Effect and influencing factors for Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis
Objective To observe the effect of Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis(pre-RA)and define the influencing factors.Methods A total of 150 pre-RA patients admitted to the Department of Rheumatology,the Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2022 to December 2022 were randomly assigned into the control group(n=75)and the treatment group(n=75).A 1∶1 propensity-matched analysis was performed to match patients,and 50 pairs were successfully matched.Patients in the control group and the treatment group were treated with conventional acupuncture and Tiaodu Tongmai acupuncture therapy,respectively.Treated for 12 weeks,the aim was to compare immunoglobulin A(IgA),IgG,IgM,C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α),erythrocyte sedimentation rate(ESR),anti-cyclic citrullinated peptide(CCP)antibody,rheumatoid factor(RF),duration of morning stiffness,number of joint swelling,joint pain score,as well as joint pain score.The generalized estimating equation(GEE)model was conducted to evaluate the influencing factors for pre-RA.Results The overall effective rate in the treatment group was significantly higher than that in the control group(92.00％[46/50]vs 74.00％[37/50],P＜0.05).IgA,IgG,IgM,CRP,IL-6,TNF-α,ESR,anti-CCP antibody,RF,duration of morning stiffness,number of joint swelling,joint pain score at week 12 in the both groups were significantly decreased(P＜0.05),the decreases in the treatment group were more prevalent compared with the control group(P＜0.05).Age,disease course,treatment method and treatment duration significantly affected the therapeutic effect of pre-RA(P＜0.05).There was an interaction between the treatment method and disease course in the multiplicative model(OR 1.642,95％CI 1.188-2.352)and the additive model(relative excess risk[RERI]8.292,95％CI 2.342-14.269;attribution ratio[AP]0.638,95％CI 0.238～1.087;synergy index[SI]3.236,95％CI 1.746-5.263),showing a synergistic effect.Conclusion The therapeutic effect of Tiaodu Tongmai acupuncture in the treatment of pre-RA is better than that of conventional acupuncture in alleviating clinical symptoms,and reducing rheumatoid factors and inflammatory factors in pre-RA patients.Age,disease course,treatment method and treatment duration significantly affect the therapeutic effect on pre-RA.There is an interaction between treatment method and disease course in both the multiplicative model and the additive model,showing a synergistic effect.
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